Mandated autism coverage is gaining ground nationwide regardless of health insurers' concerns about the impact that such mandates will have on healthcare premiums. If New York Gov. David Paterson signs a bill passed by the State Legislature last week requiring health plans to cover evidence-based, medically necessary autism screenings, diagnoses and treatments with no age or dollar caps, New York will become the 22nd state to mandate some degree of autism coverage--the 21st state (Missouri) came online earlier in June.
The New York bill passed unanimously in both houses even though "the bill sponsors acknowledge it will raise premiums up to 2 percent," Paul F. Macielak, the chief executive of the New York Health Plan Association, told the New York Times. "Each additional coverage requirement, while they may seem well intentioned, also carries a cost. Lawmakers can't have it both ways. It's hypocritical for them to criticize insurance premiums as being too high and then turn around and mandate a slew of new benefits that only drive up costs." (The New York Legislature has proposed multiple mandates this year, including potential requirements related to baby formula and prenatal vitamins.)
If Gov. David Paterson signs on the dotted line, the state health commissioner will consult with the commissioners of the Office of Mental Health and Office of Mental Retardation and Developmental Disabilities to set minimum coverage options, reports Politics on the Hudson.
In Missouri, Gov. Jay Nixon has already signed into law a bill requiring health plans to cover up to $40,000 annually for the diagnosis and treatment of autism spectrum disorders in children up to age 18, reports Ozarks First. The law, which takes effect Jan. 1, 2011, prohibits Missouri insurers from limiting the number of therapy visits a child receives, as well as preventing them from restricting or refusing to renew coverage for a policyholder on the basis of a dependent's autism diagnosis.